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Medicare Coverage: Can You Opt Out if You're Still Employed?

As more Americans work beyond age 65, navigating Medicare enrollment becomes crucial. Depending on employer-provided health coverage and personal circumstances, individuals can delay Medicare enrollment without penalties under specific conditions. Click here for article.

  1. Delaying Medicare Enrollment for Working Seniors:

  • Individuals aged 65 and older who are still working and covered by a large employer (20 or more employees) can delay enrolling in Medicare Parts A and B without facing penalties.

  • Small employers (fewer than 20 employees) require Medicare to be the primary payer once an individual turns 65.

  1. Special Enrollment Periods:

  • Medicare offers a Special Enrollment Period (SEP) for those who leave the workforce or lose employer health insurance after age 65, allowing enrollment within eight months without penalties.

  1. Medicare Part D and Employer Drug Coverage:

  • Ensure your employer's drug coverage is "creditable" under Medicare Part D standards. If not, enroll in Part D during your initial enrollment period to avoid penalties, contingent upon enrolling in Part A or Part B.

  1. Penalties for Late Enrollment:

  • Delaying enrollment in Medicare Part B incurs a 10% penalty for each 12-month period missed. This penalty is permanent and added to monthly premiums.

  1. Considerations for Medicare Parts A, B, and D:

  • Medicare Part A is generally premium-free and advisable to enroll in during the initial enrollment period.

  • Part B has premiums; delaying enrollment is feasible with employer coverage but assess penalties and coverage needs carefully.

  • Part D covers prescription drugs; ensure coverage meets Medicare standards to avoid penalties.

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